Broadly, my research focuses on adults with neurogenic communication disorders, including acquired brain injury and aphasia. My work aims to (1) increase basic understanding of the neural mechanisms that support multi-modal communication and memory and (2) inform clinical assessment and treatment to improve specificity of rehabilitation and treatment outcomes for people with brain injury. My approach to studying language acknowledges two important and inherent features: 1) Communication is multimodal. Speakers communicate meaningful information in a variety of modalities beyond speech, including gesture, facial expression, eye gaze, and vocal prosody. 2) Communication is interactive. Communication is co- constructed between interlocutors and influenced by external cues such as the communication context. Conversation is a collaboration where speakers take turns, share attention, and develop mutual understanding. These processes are highly dynamic, and a main goal of my research program is to identify ways they might be disrupted, and remediated, after brain injury.
My dissertation focuses on individuals with TBI. TBI produces diffuse axonal injury throughout the brain, reducing the integrity of the brain’s white matter tracts and overall connectivity. This widespread damage results in heterogeneous profiles of cognitive deficits. The communication impairments people with TBI demonstrate are considered to arise from domain general cognitive deficits such as impairments in attention, memory, and executive functioning. Thus, modeling these cognitive functions and their interactions with communication is essential for understanding how communication breaks down and informing treatment targets for clinical rehabilitation. Although the inherent heterogeneity of TBI presents a challenge for making brain- behavior inferences, it also affords untapped potential for informing and testing theories of the relationship between communication and cognition. Toward this aim, our lab collects deep data on individual participants with TBI, characterizing their cognitive profiles with thorough neuropsychological testing across a variety of cognitive domains as well as acquiring structural and functional neuroimaging data. I hope to leverage this rich dataset to identify the cognitive and neural systems that support speech-gesture integration and multimodal communication more broadly. My dissertation uses a combination of behavioral and eye-tracking methodologies to examine speech-gesture integration after brain injury. Using a visual world paradigm, I examine how individuals with TBI process co-occurring information from speakers’ speech and gesture in real time. Using a story retell procedure, I examine how information from gesture affects memory representation for stories across time, at immediate, 20-minute, and 1-week delay timepoints. By relating performance on these tasks to performance on neuropyschological assessments, I will explore the contribution of memory resources to speech-gesture integration. This work is supported by a National Institutes of Health F31 grant I was recently awarded to study multimodal communication and cognition in TBI.
Duff, M. C., Morrow, E. L., Edwards, M., McCurdy, R., Clough, S., Patel, N., Walsh, K., & Covington, N. V. (2022). The Value of Patient Registries to Advance Basic and Translational Research in the Area of Traumatic Brain Injury. Frontiers in Behavioral Neuroscience, 16(April), 1–15. https://doi.org/10.3389/fnbeh.2022.846919 (PDF)
Gordon, J. K. & Clough, S. (2022). How do clinicians judge fluency in aphasia? Journal of Speech, Language, and Hearing Research,1-22. https://doi.org/10.1044/2021_JSLHR-21-00484 (PDF)
Stark, B. C., Clough, S., & Duff, M. C. (2021). Suggestions for improving the investigation of gesture in aphasia. Journal of Speech, Language, and Hearing Research, 64, 4004-4013. https://doi.org/10.1044/2021_JSLHR-21-00125 (PDF)
Clough, S., & Duff, M. C. (2020). The role of gesture in communication and cognition: Implications for understanding and treating neurogenic communication disorders. Frontiers in Human Neuroscience, 14. https://doi.org/10.3389/fnhum.2020.00323 (PDF)
Gordon, J. K. & Clough, S. (2020). How fluent? Part B. Underlying contributors to continuous measures of fluency in aphasia. Aphasiology. 34, 643-663. https://doi.org/10.1080/02687038.2020.1712586 (PDF)
Clough, S. & Gordon, J. K. (2020). Fluent or nonfluent? Part A: Underlying contributors to categorical classifications of fluency in aphasia. Aphasiology, 34, 515-539. https://doi.org/10.1080/02687038.2020.1727709 (PDF)
Clough, S. & Hilverman, C. (2018). Hand gestures and how they help children learn. Frontiers for Young Minds, 6(29). https://doi.org/10.3389/frym.2018.00029 (PDF)
Hilverman, C., Clough, S., Duff, M. C., & Cook, S. W. (2018). Patients with hippocampal amnesia successfully integrate gesture and speech. Neuropsychologia, 117, 332-338. https://doi.org/10.1016/j.neuropsychologia.2018.06.012 (PDF)